Why Don’t Sumo Wrestlers Die of Heart Disease?

How many of you watched a sumo wrestling match? I’d bet not too many. Let me tell you—it is absolutely fascinating, but for reasons that have nothing to do with the sport per se.

The rules are very simple, almost childish. Two wrestlers face each other in a circle and push and shove attempting to have the opponent step outside the circle boundary. It reminded me of a game I used to play in elementary school, where two kids, hopping on one leg were pushing on each other trying to have the opponent land on both feet.

There were two things that fascinated me about the sumo match I saw in Tokyo.

The ritual

Sumo goes back hundreds of years in Japanese culture and has its roots in ancient religious rituals. Coming to think of it, the classical Greek Olympic Games were also part of religious rituals.

When the two sumo wrestlers get into the arena, they launch into an elaborate “dance”, bowing and embracing each other. Being the cynical Westerner that I am, I thought all this display of respect a bit phony; why can’t they just get down to business without wasting time on archaic rituals?

My Japanese friend set me straight. These rituals are very meaningful to modern Japanese spectators just as they were to ancient ones. They connote the philosophy that being civil to each other cannot be checked out at the door even when one is going to engage in fierce combat. In one of the matches, a Croatian wrestler, who apparently was ignorant of the importance of the Japanese attachment to the ritual, went through the motions without conviction; a murmur of disapproval wafted through the audience.

The other ritual is just as interesting. Both wrestlers cast salt on the circle’s ground. Even my Japanese friend was at a loss explaining its meaning. I later found out that, like in virtually all cultures, salt held great importance and was a symbol of well-being and friendship. Hence the custom of greeting with bread and salt. And hence the expression “salt of the earth”.

What the wrestling ritual meant was probably both an homage to the opponent as “salt of the earth”, and wishing him (there are no female sumo wrestlers, yet) prosperity and well-being. But enough of obscure rituals; this is a health blog.

The other fascinating thing

I was watching those grotesquely obese behemoths (400 pounds is considered light weight) and wondered what awaits them when their career would be over in a few years. Are they all going to get type 2 diabetes? Is their mortality rate—due to heart disease—astronomically high?

To put things in perspective, these wrestlers are not fat slobs, they are just fat. In medicine, we classify them as morbidly obese, yet there was nothing morbid about them; they had humongous heft and enormous power.

They are usually recruited from Japanese villages by scouts who scour the countryside in search of extremely fit, strapping young farm boys. They bring them to the Big City, subject them to a grueling regimen of physical training that would put the Marines boot camp to shame, and basically force-feed them.

The rationale is simple: winning in the arena depends on momentum. And in high school physics, we learned that momentum = mass x speed. So they build up their mass, and they train them for speed, agility, and overall fitness.

Once they retire from the sport, these gladiators don’t sink into a morass of depression, alcoholism, overeating, and disease. Most of them are kept on as ushers, ticket takers, etc.; and they keep in shape. I saw some of them, and I wouldn’t advise Schwarzenegger to tangle with any of them.

I inquired about their health status after retirement, and, to my surprise, they were pronounced hale and fit into their 70s and 80s. I did not have an explanation. Received wisdom dictated that these people are sitting ducks for diabetes and heart disease.

The answer, finally

I have to admit that every time I preached the benefits of weight control and the penalty sinners would inevitably have to pay, I had this nagging doubt, What about those sumo wrestlers?

In an article published in JAMA, scientists from the University of South Carolina in Columbia looked into the issue of adiposity (fatness) vs. cardiorespiratory fitness as determinants of death. In a 12-year study, researchers found that among 2603 American adults over 60 years old, those who engaged in cardiovascular activity were living longer than those who exercised less, even when they had the same amount of body fat.

Previous studies have shown that both the level of cardiovascular fitness and the amount of body fat played a role in the health of older Americans. But this study shows that cardiorespiratory fitness helps adults over 60 live longer, regardless of body fat.

The authors conclude: In this study population, fitness was a significant mortality predictor in older adults, independent of overall or abdominal adiposity. Clinicians should consider the importance of preserving functional capacity by recommending regular physical activity for older individuals, normal-weight and overweight alike.

So there, finally, the puzzle of the healthy sumo wrestlers is solved. But more importantly for us soft and overweight weaklings: exercise, exercise! It is literally a question of life and death.

Dov Michaeli, MD, PhD loves to write about the brain and human behavior as well as translate complicated basic science concepts into entertainment for the rest of us. He was a professor at the University of California San Francisco before leaving to enter the world of biotech. He served as the Chief Medical Officer of biotech companies, including Aphton Corporation. He also founded and served as the CEO of Madah Medica, an early stage biotech company developing products to improve post-surgical pain control. He is now retired and enjoys working out, following the stock market, travelling the world, and, of course, writing for TDWI.

13 COMMENTS

Ian, the ex-Sumo wrestlers that I saw and talked to (ushers and ticket agents) were more or less of normal body weight, and were religiously exercising daily. They told me (via my Japanese friend) that they are not the exception, that most of their ex-wrestler friends shed their fat and kept exercising after retiring from the sport. Hardly a scientific study, but intriguing nonetheless. The lessons one can draw from this anecdote are: 1. Never too late to lose weight and inhibit development of metabolic syndrome and progression to diabetes. 2. Exercise!

Oh come on. Weighing 400 pounds would put such a severe strain on the joints and circulatory system that no one could really be fit at that weight for long. You would have difficulty rising from a chair at that size. If Sumo wrestlers are free from health complications, it is because they are young. I want to see a man over forty who can stay healthy when that obese.

I have heard of champion shot putters, who are enormously strong and athletic, who are plagued by hypertension because of their size. Being heavy past a certain point, even if the weight is mostly muscle, is bad for you.

There is a Japanese study shows they generally live 25 to 30 years shorter than most Japanese. I was a huge fat person whose BP and Cho was perfectly normal in spite of it. I am now normal weight and still good but it’s my genetics that seems to be the answer. Lol

The China study shows a correlation between eating animal meat and heart diseases. Sumo wrestlers eat high carb diets that are very low in fat. High carbs may increase your hunger level. So while they eat more and are fat, with my info. above, this doesn’t mean they are unhealthy in the heart area.

Also, those on a keto or paleo diet, while they seem and look healthier weight wise and possibly even muscle definition wise, there is the issue of the correlation with meat and unhealthiness.

This is what I’m trying to figure out but I seem to have it summarized. In effect there are pros and cons to each side and you can’t automatically think fat is unhealthy even if it is seen as undesirable by most Westerners.

Yes some Sumo wrestlers are unhealthy and some do get diabetes ect however if you look at ALL the evidence it confirms anyone including Sumo wrestlers who do not take reasonable exercise and eat sensibly will suffer more in later life. Sumo wrestlers who play by the original rules appear to be fat but as with serious weight training for world strongest man ect they train for muscle mass not fat ask our own Mr Capes if you want a qualified opinion about that.

This is above all the dumbest article I have ever read. Sumo wrestlers ARE unhealthy. they DO die of diabetes and heart disease, and they can’t possibly be in shape lugging all that fat around. Everyone needs to stop making excuses for why being fat is OK What a bunch of BS.

Hi, thanks for writing that post. I have just come across your site and You have a new subscriber(me). By the way I’ve been writing a blog about my own weight loss anda href=http://www.jpweightlossblog.com/1/go/fat-burning-diet.htmlfat burning diet/aI would really apprectiate it if you could check out my site and let me know what you think.Thanks,Joan

This post is interesting. I’m a pharmacy student and I just learned about metabolic syndrome and insulin resistance. The professor talked about why sumo wrestlers are morbidly obese but very healthy. Sumo wrestlers have a ton of subcutaneous fat but very little visceral fat. Apparantly, only visceral fat correlates with insulin resistance.

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